Transcultural ADHD and Bioethics: Reformulating a Doubly Dichotomized Debate

A double dichotomization, of biology and culture, and of cultures (the difference presumption), is to be found in debates about Attention Deficit Hyperactivity Disorder (ADHD) in cross-cultural psychiatric and bioethics literature. The double dichotomy takes biology to explain cross-cultural similarities and culture to explain inter-cultural differences. In this paper, the double dichotomy is explored in debates on the significance of the worldwide prevalence of ADHD, and on the cogency of cross-cultural diagnosis of ADHD in the central character of Chinese classic novel The Dream of the Red Chamber. Contrary to the difference presumption, cultures are not homogenous unities that contrast in toto with one another. The Dream reveals parallels to contemporary US debates-the medicalization of human life and normative disputes about childhood behaviors. To overcome the empirical and theoretical shortcomings of the difference presumption and its underlying characterization of cultural differences, a transcultural approach is proposed and its potential advantages illustrated.